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Clinical Orthopaedics and Related Research®

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01-12-2012 | Clinical Research

Anterior Impingement Test for Labral Lesions Has High Positive Predictive Value

Authors: Takehito Hananouchi, MD, PhD, Yukihiko Yasui, MD, Kengo Yamamoto, MD, Yukiyoshi Toritsuka, MD, PhD, Kenji Ohzono, MD, PhD

Published in: Clinical Orthopaedics and Related Research® | Issue 12/2012

Abstract

Background

The anterior impingement test is intended to detect anterosuperior acetabular labral lesions. In patients treated for labral lesions its sensitivity is reportedly 95% to 100%, and in a small group of patients undergoing periacetabular osteotomy, its sensitivity was 59% and specificity 100%. However, the sensitivity, specificity, positive predictive value, and negative predict value of this test to detect these labral lesions in unselected patients with hip pain are unknown.

Questions/purposes

We investigated these four parameters (1) in unselected patients with hip pain, and (2) in three subgroups of patients with dysplasia, femoroacetabular impingement (FAI), and with an intact joint space.

Methods

We prospectively studied 69 patients (15 men and 54 women) with a mean age of 57.2 years (range, 27–81 years). One observer performed the anterior impingement test in all patients. We determined the presence or absence of an anterosuperior labral lesion with radial MRI in 107 hips (38 patients in both hips: 14 with pain, and 24 without pain). We also investigated the parameters in the three subgroups which consisted of 60 cases of dysplasia, 27 cases of FAI, and 80 cases with intact joint space; the third subgroup partially overlapped the first and second subgroups.

Results

The four parameters in all hips were 50.6% (45/89), 88.9% (16/18), 95.7% (45/47), and 26.7% (16/60), respectively. Parameters in the three subgroups were similar to those of all cases.

Conclusions

Although the sensitivity of the anterior impingement test did not reach a sufficient level for detecting anterosuperior labral lesions, we believe the high positive predictive value makes the test useful.

Level of Evidence

Level III, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Title: Anterior Impingement Test for Labral Lesions Has High Positive Predictive Value
Authors: Takehito Hananouchi, MD, PhD
Yukihiko Yasui, MD
Kengo Yamamoto, MD
Yukiyoshi Toritsuka, MD, PhD
Kenji Ohzono, MD, PhD
Publication date: 01-12-2012
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 12/2012
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-012-2450-0

At a glance: The STEP trials

Springer Medicine

Anterior Impingement Test for Labral Lesions Has High Positive Predictive Value

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Level of Evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Level of Evidence

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